The Star's health journalist on her long, hard battle with long Covid

A screenshot of the musical the writer (centre) danced in in March. The fatigue triggered by long Covid made her collapse the morning of the show, but as they say, the show must go on. — Photos: REVATHI MURUGAPPAN/The Star

Long Covid – this condition has become my close buddy for over a year now.

Our friendship is so tight that nothing seems to be able to separate us.

Yes, I’m among the millions who survived the Covid-19 infection, but continue to have symptoms that are hard to explain and manage, making daily life a struggle.

Covid long-haulers (as we are called) experience a multitude of health problems and symptoms that may emerge, persist, resolve and reemerge over different lengths of time.

It is quite a mysterious ailment and science hasn’t been able to pinpoint what causes it, or why only some people, healthy or otherwise, are affected.

New symptoms emerge

I got infected by the SARS-CoV-2 Delta viral strain in November 2021, which triggered my irritable bowel syndrome and gutted my digestive system.

By January 2022, I thought I had somewhat recovered as I was able to do running drills and sprint with my nine-year-old niece (she managed to beat me!), although it left me exhausted for a few days afterwards.

But then, aside from the persistent diarrhoea, tummy aches and nausea, which had me consulting the gastroenterologist frequently, I started developing new symptoms.

These included headaches, dizziness, anxiety, chest pain, shortness of breath, heart palpitations after the slightest exertion, and difficulty trying to find words to express myself.

An ardent lover of puzzles, I could no longer solve easy Sudoku or Kakuro puzzles.

Something was wrong; I was extremely unwell and made multiple trips to different hospitals.

All the clinical evaluations and results of a battery of blood tests, chest X-rays, ultrasounds and electrocardiograms (ECGs) came back normal.

Back then, only Covid-19 patients who were on ventilators were referred to rehabilitation, so I was discharged once my infection was stable.

The doctors did however, caution that it would take time for my digestive system to be fully functional.

As a health journalist who receives a barrage of information from prestigious medical journals, I had a hunch it was long Covid, but most specialists dismissed my suspicion as they themselves had limited knowledge of the condition.

At his wit’s end, my gastroenterologist even referred me to a psychologist.

Initially, I was livid, but later started believing that I was indeed sick in the head.

Five counselling sessions later, the psychologist remarked that my mind was well, but my body was not.

I was occasionally on medical leave, but guilt set in as our health team comprises only two people.

So I pushed myself to work regular hours, but after 10 minutes at the computer, I’d have to lie horizontal because I would be overwhelmed with fatigue.

To keep my stomach calm and minimise toilet runs, my meals comprised mainly soup, rice porridge and liquid nutrition.

Every time I had a work assignment, I’d fret over whether I could make it to the venue without having to turn back for a toilet call.

Poor oxygenation

In February 2022, I was slated to teach at a fitness marathon for cancer survivors, and unsure if I could do it, I decided to call my sports medicine physician for tips on how to get my fitness up quickly.

The bruises that appeared along the vein of the writer’s right thigh, which were never definitively diagnosed.

While I would’ve breezed through the four-hour marathon prior to getting Covid-19, I now had doubts if I could stand an hour of teaching in front of thousands.

He knew I had a high level of cardiovascular fitness and scheduled me for a VO2 max test – the oxygen uptake test, which shows how much oxygen your body absorbs and uses while working out.

It basically reveals how well your heart pushes blood to your muscles and how efficiently your muscles can extract that oxygen from your circulating blood.

I barely walked on the treadmill for 10 minutes before my heart rate soared to 170 and the doctor stopped the test.

My VO2 max results shocked him (and me) – it was in the bottom 20%.

The SARS-CoV-2 virus had possibly damaged my heart and lung function.

“It’s okay, just pace your workouts, don’t run or do high intensity stuff, and you’ll slowly improve,” he suggested.

The test left me drained and in bed for a week.

Thanks to my work, I was interviewing numerous medical experts locally and internationally.

One traditional medicine practitioner suggested I try acupuncture to treat my nausea, and yes, after one session, I noticed a 50% reduction in symptoms.

It wasn’t until I was interviewing a rehabilitation physician on long Covid that I realised I was worse off than some of those who had been ventilated and recovered.

In fact, after hearing my story, the physician empathetically said I probably needed to be warded because my symptoms were pretty severe.

I wasn’t alone!

In April 2022, I went for a long Covid assessment at a private rehabilitation hospital and my diagnosis was confirmed.

Since the hospital was near my house, the physician recommended physiotherapy thrice a week instead of admission, easing my financial burden.

I started with the spirometer to monitor my breathing and simple sit-to-stand exercises, along with slow walking on flat ground.

After every exercise, I’d have to lie flat for 10 minutes before proceeding further.

We had to switch to once-a-week sessions to cater for my long post-workout recovery.

In time, my lungs improved and I was able to walk 5,000 steps without chest pain and palpitations.

I was even allowed to do five jumping jacks!

All was going well until the therapist noticed some bruising on my inner knees.

They were extremely tender and painful to touch; eventually, they spread angrily to my right inner thigh.

I had difficulty walking and the rehabilitation physician rushed over, but couldn’t figure out what it was.

Next stop: Dr Dermatologist.

Once again, I was put through a series of blood tests and scans that revealed nothing – thankfully, no blood clots!

His uncertain diagnosis: erythema nodosum, a condition where the fat within the skin becomes inflamed.

By this time, I had seen a gastroenterologist, infectious disease physician, dietitian, psychologist, cardiologist, rehabilitation physician, dermatologist and sports medicine specialist, along with traditional Chinese and Ayurveda practitioners, faith and spiritual healers.

The medical expenses left a gaping hole in my pocket and the medicines prescribed would have enabled me to open a mini pharmacy!

The handsome dermatologist advised me to take six months off work as the stress was wreaking havoc on my body.

And so in August 2022, I took three months off work to heal (the thought of leaving my editor to run the health desk alone made me reluctant to take all six months off).

I joined an international long Covid peer support group online (it has over 61,000 members) and what a difference that made!

I definitely wasn’t losing my mind or alone in my journey as many others were also dealing with similarly debilitating symptoms, even three years after the initial infection.

Members stress on the importance of pacing, building up slowly, resting and having patience.

Besides daily breathing exercises, I did gentle yoga, meditated, walked, solved puzzles and kept a gratitude journal in my mind.

I rarely ventured out and lost interest in social events and meeting friends as talking for long periods would wipe me out.

To dance again

One morning last September (2022), my former dance teacher called to ask if I’d like to dance in a charity show she was producing in March.

The writer shows her coated, swollen tongue (note the teeth marks) – an indication of dehydration and digestive issues – during her second Covid-19 infection.

Momentarily, I forgot my pain as dance is my passion and said yes.

Aware of my condition, she was confident I’d spring back to life in six months.

The long rehearsals were brutal, but therapeutic, although sometimes, I’d pass out once I got home.

My fitness improved and by the time I returned to work in November (2022), I was 70% better.

Alas, I succumbed to another Covid-19 infection in January (2023) and the nightmare began all over again.

On showday morning, I actually collapsed, but refusing to be defeated, I pushed myself on to perform.

The following week, I landed at the hospital’s emergency ward as my heart started to beat too fast (140 beats per minute) and wouldn’t slow down.

Again, I was warded and subjected to multiple tests and scans (all normal).

Despite the drugs administered, my heart would sometimes decide to tick to its own beat and rhythm, and spike my blood pressure, even while I was asleep, perplexing the cardiologist.

The second gastroenterologist then put me on low dose anti-depressants for three months to tackle both the diarrhoea and headaches.

The relapses still continue, but are less frequent now.

These days, I’m a shadow of my former fit self; my drugged body has become an alien to me; my muscles have atrophied; and like other Covid long-haulers, I can’t do more than one activity a day or partake in sports or outdoor pursuits I once enjoyed.

Often, I cancel engagements at the last minute because I just feel sick.

Perhaps it would have been better had I not survived Covid-19, because I really can’t see an end to this relentless condition.

Indeed, there are many cases of Covid long-haulers taking their own lives, unable to bear the trauma any longer.

Patience, patience, patience, I remind myself.